27th Annual Golf Tournament
Friday, June 2, 2017
Registration/Lunch 11am · Shotgun Start 12:30 pm
Excelsior Springs Golf Course · 1201 E. Golf Hill Dr.
816.630.3731 · excelsiorgolf.com
All inclusive $160 per player
Four Person Scramble
Includes: golf, cart, two mulligans, raffle ticket, putting contest,
all hole prizes, lunch and drinks. Cash prizes awarded per flight.
Proceeds will be used to install privacy doors for outpatient
procedure rooms.
SENIOR PLAYERS
60-69 hit from the Gold Tees
70 and up hit from the Red Tees
Additional details and registration information on back.
SPONSORSHIP LEVELS
PLATINUM-$15,000
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Entry for 3 teams
Full page ad in program
Hole & Cart Signage
Recognition on Gift
Entry for 1 golfer
Listing in program
Hole Signage
Entry for 2 teams
1/2 page ad in program
Hole & Cart Signage
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Entry for 1 team
1/4 page ad in program
Hole & Cart Signage
DRIVING RANGE-$500
BEVERAGE CART-$500
Only 1 available
 Entry for 1 golfer
 Listing in program
 Hole Signage
Only 2 available
 Entry for 1 golfer
 Listing in program
 Cart Signage
HOLE SPONSOR-$500
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SILVER-$2,500
GOLD-$5,000
BRONZE-$1,500
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Entry for 1 team
Listing in program
Hole & Cart Signage
CART SPONSOR-$100
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Listing in program
Cart Signage
PLAYER ENTRY FORM
Please complete this form and the Payment Form below. Return with payment by May 26, 2017. Registration will not be
accepted without payment. Telephone registrations may be made with a credit card. For more information call Jeanne Buckman
at 816.629.2768 or email [email protected].
PLAYER
NAME
MAILING ADDRESS
DAYTIME
PHONE
1
(
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2
(
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3
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)
4
(
)
EMAIL
SPONSOR ENTRY FORM
Please complete this form and the Payment Form below. Return with payment by May 26, 2017 in order to assure you receive
acknowledgment of your sponsorship. Sponsorship is not confirmed until payment is received. For questions call Jeanne Buckman at 816.629.2768 or email [email protected].
COMPANY NAME
CONTACT NAME
DAYTIME PHONE
(
SPONSORSHIP
AMOUNT
EMAIL
)
PAYMENT FORM
Excelsior Springs Health
Care Foundation is a 501(c)
Payment can be made by check or credit card. Make checks payable to ESHC Foundation.
My check or credit card information is enclosed for the following (please mark all that apply).
3 not-for-profit facility.
 Player: $__________________________________________________________________
 Donation. I cannot attend but I would like to make a donation in the amount of $___________________________________
 Sponsorship: $________________________________________________________________________________________
Cardholder’s Name: _______________________________  MasterCard
Card Number:                
Expiration: 
 Visa
/ 
 Discover
 Other
Total Amount: $___________ Cardholder’s Billing Zip Code: _________ Signature:________________________________
Return payment and entry form by May 27 to ESHC Foundation, 1700 Rainbow Blvd., Excelsior Springs, MO 64024.